Report: Healthcare quality improving, access still deficient

The overall quality of healthcare improved from 2000 to 2011, yet Americans still only received 70% of recommended medical services, according to the 2013 National Healthcare Quality Report and National Healthcare Disparities Report by the Agency for Healthcare Research and Quality. The National Healthcare Quality Report focuses on national trends in the quality of healthcare provided to the American people, while the National Healthcare Disparities Report focuses on prevailing disparities in healthcare delivery as they relate to racial and socioeconomic factors in priority populations, according to a news release.

The reports also indicate three-quarters of hospital quality measures showed significant improvement, compared with 60% for home health and nursing home care, and about half for ambulatory settings. For instance, healthcare-associated infection and hospital readmission rates are falling, and quality of care during the period improved for measures on adolescent vaccination, HIV treatment, colon cancer surgical care and hospital care for patients with heart problems and pneumonia, while quality of care declined for measures on diabetic checkups, Pap smears, maternal deaths at delivery and receipt of asthma preventive care.

“Hospitals are clearly engaged in efforts to improve healthcare quality in the United States,” AHRQ Director Richard Kronick, PhD, said in the release. “The intense national focus on quality improvement in hospitals is starting to pay off, but much work remains to make sure that all Americans have access to high-quality care in every setting.”

The reports found deficiencies regarding healthcare access, with 26% of Americans (especially racial and ethnic minorities and low-income people) reporting difficulties getting care. Most disparities in quality of care that were related to race, ethnicity or income showed no significant change, according to the release. However, for blacks, Hispanics, Asians and poor people, the number of disparities showing improvement was larger than the number of disparities that were getting worse.

Trend data is included for most measures of quality and disparities from 2000-2002 to 2010-2011. This data is based on hundreds of healthcare measures categorized in several areas of quality, including effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure and access. Since the data predates implementation of most of the Medicaid expansions and health insurance exchanges included in law, the reports’ findings do not reflect progress made under the ACA. However, the data will serve as a baseline for tracking progress under the Affordable Care Act in coming years, according to a news release.

The U.S. Department of Health and Human Services Partnership for Patients initiative, HHS’ Centers for Medicare & Medicaid Services quality reporting programs, such as the Hospital Inpatient Quality Reporting Program and Hospital Outpatient Quality Reporting Program, and private-sector initiatives such as those sponsored by the Institute for Healthcare Improvement have been catalysts for the current quality improvement effort in hospitals, according to the release.